A case is described of a man who castrated himself while depressed over deviated sexual urges, with eventual favorable response to psychiatric hospitalization and psychotherapy. The literature on self-mutilation is then reviewed, comparing 26 cases of enucleation of eyes, cutting off a hand, mutilating genitals (by males) and cutting out the tongue. Recommendations for treatment and study are attention to previous history or evidence of self-injury, preoccupation with Biblical passages regarding self-injury, preceding drug abuse and early loss of the father in males. Rapid tranquilization and intensive psychotherapy are advised following hospitalization.